Book review

Pioneers in Abdominal Surgery. By Z. Cope, M.D., M.S., F.R.C.S. Pp. xii., 135. Illustrated. London : Oxford University Press (Humphrey Milford). 1939. Price 7s. 6d.? This is a very interesting little essay in the history of surgery. The author passes in review each of the standard operations for acute abdominal conditions, beginning with intestinal obstruction and passing on to appendicitis, perforated gastric ulcer, and ruptured ectopic pregnancy, and describes the first recorded operation for each. A valuable feature is the excellent series of photographs, thirty-one in all, of the pioneers, derived from many countries. Naturally, Great Britain is well represented.

can scarcely be regarded as a student's text-book for systematic study, for the average student does not like Applied Anatomy, nor does he appreciate its value and importance. This boo v, then, must find its chief function as work of reference 01 01 occasional consultation. In such a capacity it could hardly e found wanting, for the range of the information contained in it is vast, the facts are presented in a simple and systematic way, and few omissions or statements open to challenge are to e found. It is curious, perhaps, to find no mention of strangulated hernia, nor of that great life-saving measure, Fowler s position, and its anatomical explanation. A brief mention of the problems connected with ascites, and the operations designed for its relief or cure might well be included. A word of warning might be given as to where the ureter is to be found after the peritoneum has been stripped back, for it sticks to the Peritoneum and does not lie in the extra-peritoneal fat oveilying the iliac vessels. We have seen inexperienced operators seeking it here in vain. It is interesting to see a reference to a case which seems to support the possibility of an occurrence which some might rate impossible, namely the escape of an ectopic testis down the femoral canal. Altogether a most stimulating book and full of interest : a search of its pages can hardly fail to be helpful to one in difficulty over a problem ?f Anatomy, whether commonplace or obscure. The new edition should enhance a reputation already earned by its predecessors. bibliography has collected, and the long list of references at the end of each chapter shows the wealth of material that has been consulted. Two-thirds of the book is devoted to an account of the author's personal experience, and where alternative methods in the practical aspect of blood grouping and transfusion exist, the most practical procedure is described to the exclusion of the rest. Inevitably this will lead to the Personal criticism of certain methods of technique. In this case, however, the procedures have been so simplified, the Kiethods so fully described and every step so beautitu y illustrated, that even those experienced in the art of blood transfusion will acquire many new points of view which will be of ultimate practical value. No aspect of the indications, complications, dosage and rate of administration is omitted, and the old standing custom of transfusing a patient with the empirical quantity of one pint is finally relegated to the past. The latter part of the book discusses the modern methods of technique available for collecting and delivering blood. The therapeutic value of whole, citrated and stored blood is considered, except that the subject of stored blood is of necessity incomplete. This is undoubtedly the most complete work available, and it can be confidently recommended to all members and students of the profession, and especially to those physicians and surgeons who are personally concerned in the performance of blood transfusion. Price 15s.?" Good wine needs no bush," and little recommendation is needed for a text-book which has reached its fifth edition in seven years.
The present edition includes several new illustrations in addition to details of methods of treatment which have come into general use since the last edition, one of the most notable being the use of emulsifying bases. X-ray dosage is now given in r-units as well as in pastilles. Common Skin Diseases has reached the established place which was predicted for it in 1932, and is probably the most popular smaller work on dermatologv in use at the present time. It can be recommended without any hesitation to both students and practitioners. Bailliere, Tindall andCox. 1939. Price 2s. 6d.?In 1938 the Bath and Bristol Mental Health Society arranged a course of lectures on the Psychological Aspect of Delinquency, and these are now reproduced in pamphlet form. Each of the six talks was given by a different lecturer, three of them Bristol doctors. The address by the Director of the Tavistock Clinic on " the Magistrate and Delinquency " is outstanding. The booklet suffers from a lack of cohesion, the treatment of the subject is elementary and much is left unsaid. In fairness to the organizers of the course it should be pointed out that each talk was followed by an hour's discussion, when many problems receiving scant attention in the lecture could be developed. Each address by itself is quite readable, but the absence of an index makes cross-references difficult. This book would be of interest to anyone wanting to obtain a superficial knowledge of the subject, and it may well prove thought-provoking to those who are accustomed to t e o er Call attention to the great vaJue of the very numerous illusti at ions. To glance through these is by itself an excellent education in clinical surgery. In the present edition moie ^nd better pictures have been introduced, and another new feature is a series of footnotes explaining who the various surgeons are (or were), whose names have been given to signs 0r diseases. Altogether an excellent book, both for students and for doctors. It is very well printed and published, as one w?uld expect from the famous house that has turned it out. ?This book might well be read with advantage by all surgeons likely to have to deal with abdominal war wounds. Those who have dealt with these conditions know full well that there are many important details in the operative technique which do not arise in ordinary abdominal surgery. The author has not set out to write a treatise on the subject, but offers, as he says, the book as a companion guide to the illustrations.
These illustrate, well and clearly, many important points in surgery of this kind, and the text has much excellent advice to offer as to the type of case it is wise to leave alone, those on which transfusion, which has improved on the results of the last war, should be done, and those in which there should be no delay in treating operatively. He also emphasizes the necessity of speed ; the " surgical tortoise," as he rightly says, is not conducive to living results, and this without doubt will be confirmed by all surgeons who have had to deal with these cases in large numbers. Transfusion, thorough search of the gut from end to end, gentleness and speed in handling with the least possible exposure of the organs are the methods to be employed if the patient is to survive. The chapter on low back strain and sciatica is a very helpful inclusion. As the author truly says, there have been innumeiable methods designed for introducing Smith-Peterson pins into a fractured neck of the femur. His method does not appear the best. Perforation of the femoral artery in using the Hey Groves apparatus for this purpose can only be accounted for by a lapse in the elementary precaution of feeling for the arterial pulsation, which in the abducted leg is always medial to the point overlying the centre of the femoral head. There is an occasional jarring note provided by an overstatement, as for instance when a rather unpleasantlooking guillotine amputation is shown in illustration 107 with the caption " A result of skeletal traction." No method pf treatment is free from its tragedies, most of these occurring in incompetent hands. After making out a well argued case for traction through the lower third of the tibia, confusion is spread by nearlv every illustration showing traction through the os calcis as is the more usual practice. This contribution to the literature on fractures has the great attribute of being freely and excellently illustrated and having a text which is clear and concise, and in which a logical reason is always given to satisfy the enquiring mind.
This book will undoubtedly be widely and profitably read. (which is useless), to " drain " (which is pernicious) and to " combat septicaemia " (which is vague). The iodine-in-milk treatment for actinomycosis is not noticed, nor the salvarsan treatment for anthrax. A good, practically new, section is contributed by Norman Dott on neurological surgery, and well demonstrates the great progress that has been made in the diagnosis and treatment of injuries and diseases of the brain. They represent the compressed knowledge of an eminently sound surgeon of ripe experience. The author writes in a good didactic style, avoids digression, and gives to each of the various types of emergency a well-proportioned space.
Sprinkled throughout the book are helpful classifications of symptoms, comparative tables of differential diagnosis and first-rate diagrams which are as lucid and telling as any the reviewer has seen in surgical works. Constant reference to this handy and inexpensive volume would enable the resident to get far more value out of a hospital appointment, and would help the general practitioner in his vital, but less frequent contact with the acute abdomen.
Illustrated. London : Oxford University Press (Humphrey Milford). 1940. Price 2s. 6d.?This notebook is a welcome addition to the Library at this particular time. Its size is not unwieldy and at the same time gives plenty of space for note taking. The diagrams are clear and boldly drawn, three essentials being well portrayed : (a) The Gross Anatomy. (b) Common Types of Fracture and Dislocation, (c) The First Aid Treatment of Serious Hemorrhage. The Anatomical diagrams show at a glance the subject portrayed and leave the student space for marking in the names of the various parts. Unlike the official first aid text-books, this treats the subject